<%-- 
    Document   : jspReportePromotor-Medico
    Created on : 20/09/2011, 12:26:25 AM
    Author     : yohanna
--%>

<%@page contentType="text/html" pageEncoding="UTF-8"%>
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
   "http://www.w3.org/TR/html4/loose.dtd">

<html>
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
        <title>JSP Page</title>
    </head>
    <body>
        <form class="jotform-form" action="http://submit.jotform.com/submit.php" method="post" name="form_12611411238" id="12611411238" accept-charset="utf-8">
  <input type="hidden" name="formID" value="12611411238" />
  <div class="form-all">
    <h2 id="header_1" class="style1">Reportes Promotores-Medico
          </h2>
	<h2 id="header_3" class="style3">Reportes Oficina de Promotores y Médicos.
	</h2>
	<h2 id="header_4" class="style2">Seleccione el tipo de reporte que desea generar presionando una de estas opciones
          .</h2>
	<p>&nbsp;</p>
	<p><span class="form-radio-item" style="clear:left;">
	<input type="radio" class="form-radio" id="input_5_0" name="q5_generarNinos" value="Opción 1" />
	<label class="form-label-left" id="label_5" for="input_5">Generar Niños
	</label></span></p>
	<p><span class="form-radio-item" style="clear:left;">
	<input type="radio" class="form-radio" id="input_6_0" name="q6_ninosVinculados" value="Opción 1" />
	<label class="form-label-left" id="label_6" for="input_6">Niños Vinculados&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
	</label></span>
            <button id="input_9" type="submit" class="form-submit-button">
              Generar
            </button>
          </p>
	<p><span class="form-radio-item" style="clear:left;">
	<input type="radio" class="form-radio" id="input_7_0" name="q7_ninosDesvinculados" value="Opción 1" />
	<label class="form-label-left" id="label_7" for="input_7">Niños Desvinculados&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
	</label></span>
            <button id="input_10" type="submit" class="form-submit-button">
              Salir
            </button>
          </p>
	<p><span class="form-radio-item" style="clear:left;">
	<input type="radio" class="form-radio" id="input_8_0" name="q8_informacionDe" value="Opción 1" />
	<label class="form-label-left" id="label_8" for="input_8">Información de Comedores</label></span></p>
	<p>&nbsp;</p>
	<ul class="form-section">
      <li style="display:none">
        Should be Empty:
        <input type="text" name="website" value="" />
      </li>
    </ul>
  </div>
  <input type="hidden" id="simple_spc" name="simple_spc" value="12611411238" />
  <script type="text/javascript">
  document.getElementById("si" + "mple" + "_spc").value = "12611411238-12611411238";
  </script>
</form>
        <h1>Hello World!</h1>
    </body>
</html>
